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Sixty percent to 97% of patients on maintenance hemodialysis therapy experience fatigue, which is associated with an increased risk for cardiovascular events, mortality, and decreased quality of life. Patients describe hemodialysis-related fatigue as debilitating, preventing them from being able to work and limiting their participation in social and recreational activities. Patients have rated fatigue as of higher importance than death ... Read More »

Among adults with hypertension, studies have shown that a reduction in sodium intake is significantly associated with lowering of blood pressure. In a 2010 report on strategies to reduce sodium intake, the Institute of Medicine (IOM; now the National Academy of Medicine), said, “A more accurate measure of total sodium intake such as 24-hour urine collection should be employed in ... Read More »

Chronic kidney disease (CKD) is a major risk factor for cardiovascular events. According to Yazid N. Al Hamarneh, BSc(Pharm), PhD, and colleagues, “patients with CKD are underserved when it comes to cardiovascular risk reduction efforts.” Approximately one in 10 adults in Canada are living with CKD and suboptimal treatment to reduce the risk of cardiovascular events is associated with an ... Read More »

The mainstay therapy to reduce the risk of stroke in patients with atrial fibrillation is warfarin. Thromboembolic risks are reduced with the use of target international normalized ratio (INR) between two and three without a significant increase in the risk of major bleeding. Compared with the general population, the risk of thromboembolic events is higher in patients with advanced chronic ... Read More »

For older patients with kidney disease, many of whom have limited life expectancy and a significant burden of symptoms and comorbidities, health-related quality of life is increasingly being recognized as an important patient-centered outcome. Instruments designed to measure health-related quality of life include items related to physical health, mental health, symptoms, and limitations. In older patients with kidney disease, prognostication ... Read More »

High plasma phosphate concentration, hyperphosphatemia, is an electrolyte disturbance in patients with chronic kidney disease (CKD); 40% of 45% of patients with end-stage CKD experience it. The usual treatment to maintain phosphate concentrations in the normal range is dialysis. In general, maintaining a normal phosphate balance in patients on dialysis is desirable because it may help prevent severe complications such ... Read More »

In patients with chronic kidney disease (CKD), concentrations of plasma uric acid increase due to reductions in glomerular filtration rate (GFR). Hyperuricemia is associated with gout and is also a suspected risk factor for other conditions associated with metabolic syndrome, including hypertension, diabetes mellitus, and cardiovascular diseases. Acute kidney injury may also occur in the presence of high uric acid, ... Read More »

CHRONIC KIDNEY DISEASE Nondepressive Psychosocial Factors and Risk of CKD in Black Americans Clinical Journal of the American Society of Nephrology. 2018;13(2):213-222 Researchers led by Joseph Lunyera, MD conducted a study to examine the association of nondepressive psychosocial factors with risk of chronic kidney disease (CKD) among black Americans. Data from the Jackson Heart Study were utilized for the current ... Read More »

Two-Day Workshop Presents Data on Use of Earlier Markers of CKD Progression In mid-March, the National Kidney Foundation, in collaboration with the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA), concluded a scientific workshop to review the results of a major, multi-year meta-analysis designed to examine the “largest compilation of data ever collected on chronic kidney ... Read More »

To enable individuals with chronic kidney disease (CKD) to successfully self-manage their condition, renal clinicians and other care providers employ varying educational and behavioral strategies to support those efforts. Self-management requires patients to be able to monitor their disease, manage symptoms, interpret results of home-monitoring therapies, and adhere to complex treatment regimens and dietary and fluid restrictions. Some patients also ... Read More »